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How to use a metered dose inhaler (puffer) with a spacer for children

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How to use a metered dose inhaler with a spacer for children

  1. Assemble spacer and place face mask onto the end of the spacer.
  2. Check the medication device dose counter and the expiry date – never use the medication after this date.
  3. Remove the mouthpiece cover.
  4. Hold inhaler upright and shake well.
  5. If this is the first time using the inhaler, or if it hasn’t been used it in a while, it will need to be primed before placing it into the spacer. Press down on the canister to release two “puffs” of medication (some medications require 4 puffs to prime – please read the instructions for your particular device).
  6. Insert inhaler upright into spacer.
  7. Sit upright.
  8. Breathe out gently to empty your lungs (if possible).
  9. Place the face mask over the nose and mouth, ensuring a good seal around the edges with no gaps between the mask and skin.
  10. Hold spacer level and press down firmly on canister to release one puff of medication into the spacer.
  11. Breathe in and out normally for 4 breaths. Do not remove the facemask and spacer in between breaths.
  12. If more than one dose is needed, repeat all steps. You can leave the metered dose inhaler in the spacer to shake it before the next puff.
  13. After the required number of puffs have been given, remove inhaler from the spacer.
  14. Replace the mouthpiece cover on the inhaler.

If using a steroid inhaler, remember to rinse your mouth after use.


Spacer care

Getting the most out of your inhaler

Ask your doctor, pharmacist or asthma & respiratory educator to:

Different brands of inhalers sometimes have slightly different instructions to each other for similar steps. The checklists in our How-to video library have been simplified and standardised where possible to reduce confusion.

Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.

Other inhaler types

See our complete How-to video library for other inhaler types and how to use them.


Thanks to Ms Narelle Williamson, Asthma and Respiratory educator, and the patient who participated in this film clip.


Although all care has been taken, this video is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.